27-09-2024 | Pharmacokinetics | Editorial
The concept of “fictitious weight” in pharmacokinetic simulations and target-controlled infusion
Author:
Shinju Obara
Published in:
Journal of Anesthesia
Login to get access
Excerpt
Zhong and Xu recently published a paper titled “General Purpose Propofol Target-Controlled Infusion Using the Marsh Model with Adjusted Weight Input” in
Journal of Anesthesia [
1]. This study aimed to improve the performance of target-controlled infusion (TCI) in adjusting the gap between predicted propofol concentrations and actual plasma levels. This improvement is achieved by mimicking the TCI behavior of the Eleveld model [
2], which is currently considered the best model, through modifying the input weight in the Marsh model. The Marsh model is adopted by the Diprifusor system [
3,
4], the only TCI system available in Japan. To understand the concept of Zhong and Xu’s study, it is essential to understand the foundational principles regarding how patient characteristics influence the pharmacokinetics (PK) of commonly used anesthetic drugs, and consequently, their impact on PK simulations and the predictive performance of TCI. This paper explains these concepts using propofol as the primary example, and also provides supplementary information on remifentanil and fentanyl. …